1. Point-of-care procalcitonin may predict the need for surgical treatment in patients with small bowel obstruction
- Author
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Minoru Hayashi, Shinsuke Tanizaki, Shigenobu Maeda, Taizo Nakanishi, Misaki Murasaki, Ryo Shigemi, Ken-ichi Kano, Hideya Nagai, Kumiko Kono, and Hiroshi Ishida
- Subjects
Male ,medicine.medical_specialty ,Calcitonin Gene-Related Peptide ,Point-of-Care Systems ,Risk Assessment ,Gastroenterology ,Procalcitonin ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Predictive Value of Tests ,Internal medicine ,Intestine, Small ,parasitic diseases ,Humans ,Medicine ,In patient ,Prospective Studies ,Surgical treatment ,Aged ,Point of care ,Aged, 80 and over ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Emergency department ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,Bowel obstruction ,Baseline characteristics ,Emergency Medicine ,Female ,business ,Intestinal Obstruction ,hormones, hormone substitutes, and hormone antagonists - Abstract
The early identification of patients with small bowel obstruction who require surgical treatment could potentially lead to improved patient outcomes. We evaluated the efficacy of point-of-care procalcitonin for predicting surgical treatment among patients with small bowel obstruction.This was a prospective observational study. We measured serum procalcitonin levels in patients who presented to the emergency department and were diagnosed with small bowel obstruction from April 1, 2018 through March 31, 2019. Patients were grouped into two groups: the elevated procalcitonin and normal procalcitonin groups. Our primary outcome was surgical treatment.A total of 53 patients with small bowel obstruction were included in the study, and 11 patients (20.8%) were treated operatively. Baseline characteristics were similar, except for age, between the elevated procalcitonin (≥0.12 ng/ml) and normal procalcitonin groups. The elevated procalcitonin level was significantly correlated with surgical treatment and hospital length of stay (p 0.05). The sensitivity, specificity, and positive likelihood of procalcitonin for the former were 45.5%, 85.7%, and 5.0 respectively.The patients with small bowel obstruction who had elevated procalcitonin levels on presentation showed significantly higher rate of surgical treatment than those who had normal procalcitonin levels. Point-of-care procalcitonin might predict the need for surgical treatment in patients with small bowel obstruction and could be used as an additional diagnostic test. Further studies with more patients are needed to investigate the predictive value of point-of-care procalcitonin for surgical treatment.
- Published
- 2020